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Adult Day Care / Adult Day Care Bath

Tier 1 Services

Page posted: 10/01/03

Page reviewed: 12/26/13

Page updated: 3/10/14

Legal Authority

Federally approved BI, CADI, CAC, and DD waiver plans

Definition

Adult day care: Planned program of activities designed to meet the health and social needs of persons with functional limitations age 18 years and older.

Adult day care bath: Bath provided by an adult day care provider when it is not able to occur in the person’s home.

Covered Services

The disability waivers pay for adult day care service in the following settings:

  • • Family or family foster care home (called family adult day services)
  • • Free-standing adult day care center
  • • Hospital
  • • Medical clinic
  • • Nursing home
  • Adult day care provides a variety of services to adults who need supervised care outside their residence during the day. These individualized services must relate to the person’s functional limitations and provide the supports necessary to either maintain or improve the person’s capability for self-care. Services include:

  • • Adult day care bath
  • • Assistance
  • • Care
  • • Meals
  • • Social or health related activities
  • • Supervision
  • • Training
  • Adult day care bath is limited to two, 15-minute units of service per day.

    Note:

    Family adult day services are also available to people ages 18 or older who have a serious and persistent mental illness or a developmental disability.

    Minnesota Senior Health Options (MSHO) covers adult day care/adult day care bath.

    Non-Covered Services

    Licensed adult foster care providers cannot provide family adult day services or adult day care bath to foster care recipients residing in the adult foster care home.

    Persons enrolled in a Prepaid Medical Assistance Program may not access adult day care bath as a waiver service. Baths are included as part of their basic PMAP benefit.

    The cost of transportation is not included in the rate paid to providers of adult day services.

    Secondary Information

    Adult day care services cannot exceed 12 hours in one 24-hour period.

    In order to be covered as a waiver service, the adult day care service must:

  • • Offer opportunities to participate in community groups such as senior citizen centers or clubs, generic service organizations, and adult education
  • • Provide age-appropriate tasks and materials
  • • Provide community integration opportunities enhancing social and physical interaction with people without disabilities
  • • Provide specialized therapies, alternative communication or other adaptive equipment as the community support planning team determines necessary
  • Provider Standards and Qualifications

    Adult day care services (enrollment required tier 1 service)

    Adult day care centers and adult day services centers must meet standards in Minn. R. 9555, parts 9600 to 9730.

    Family adult day services

    Family adult day services must meet standards in Minn. Stat. §245A.143 or Minn. R. 9555, parts 5105 to 6265. If you hold a license as an adult foster care provider and meet the family adult day services standards, DHS does not require you to obtain a separate family adult day services license.

    Licensed adult foster care home

    License holders must:

  • • Assess the compatibility of all participants and residents to ensure health and safety needs are being met
  • • Obtain written consent from foster care recipients and/or their legal representatives
  • Staff providing supervision, oversight and supportive services must:

  • • Demonstrate knowledge of participant's specific disability and/or medical condition
  • • Meet additional qualifications specified in the participant's community support plan
  • For a list of all adult day care providers in the State of Minnesota, click on DHS licensed programs and select: adult day care under type of service.

    Minn. Stat. chapter 256B.4912, subd.1 (3b) (3c) and the federal waiver plan requires this service to apply the standards of Minn. Stat. chapter 245C concerning criminal background studies to staff that provide direct contact, as defined in Minn. Stat. 245C.02, subd. 11 and service owners and managerial officials overseeing the management or policies of services that provide direct contact. Providers are required to complete and submit individual background studies using New Electronically Transmitted Study (NETStudy) through DHS licensing.

    Lead Agency Responsibilities

    County or tribal agencies act as agents for the state Medicaid agency (DHS) and are responsible to administer programs.

    Service Authorization/

    Rates/Billing

    Service authorization

    The case manager/service coordinator completes the MMIS Waiver Service Agreement by adding the vendor’s name, provider number, appropriate code, number of units and rate authorized. BI, CAC, CADI and DD Waiver general process and procedure authorization.

    Rates and billing

    Waiver Rates and Billing Page

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